Hickman line

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A Hickman line is an intravenous catheter used for the administration of chemotherapy or other medications. Hickman lines may remain in place for extended periods and are used when long-term intravenous access is needed.

The insertion of a Hickman line is usually done under sedation or a general anesthetic by a radiologist or surgeon. It involves two incisions, one at the jugular vein and one on the chest wall. At the former, a catheter is inserted into the vein and advanced into the superior vena cava. It is then tunneled under the skin to the second incision. The first one is then sutured. Throughout the procedure, ultrasound and X-rays are used to ascertain the positioning of the catheter.

Potential complications include hemorrhage and pneumothorax during insertion and thrombosis or infection at later stages.

Long-term venous catheters became available in 1968, and the design was improved by Broviac et al in 1973. Hickman et al, after whom the system is named, further modified the principles with subcutaneous tunneling and a Dacron cuff that formed an infection barrier. Dr Robert O. Hickman was a pediatric nephrologist at the Seattle Children's Hospital and Regional Medical Center.

References

Broviac JW, Cole JJ, Scribner BH. A silicone rubber atrial catheter for prolonged parenteral alimentation. Surg Gynecol Obstet 1973;136:602-6. PMID 4632149.
Hickman RO, Buckner CD, Clift RA, Sanders JE, Stewart P, Thomas ED. A modified right atrial catheter for access to the venous system in marrow transplant recipients. Surg Gynecol Obstet 1979;148:871-5. PMID 109934.

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